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Composite follicular variant of papillary carcinoma and mucoepidermoid carcinoma of thyroid gland: a case report.

Jung YH, Kang MS - J. Korean Med. Sci. (2010)

Bottom Line: By immunohistochemistry, columnar cells and squamoid cells in mucoepidermoid carcinoma were positive for cytokeratin but negative for thyroglobulin, TTF-1 and calcitonin.Positivity of p63 was seen in squamoid cells and basal cells of cysts.Some mucocytes are CEA positive.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Pusan Paik Hospital, Inje University, Busan, Korea.

ABSTRACT
A 50-yr-old male presented a thyroid mass with dysphasia and hoarseness. He underwent total thyroidectomy and neck node dissection. Pathologically, the tumor had two distinct tumor components with intermingled areas: follicular variant of papillary carcinoma and mucoepidermoid carcinoma. Mucoepidermoid carcinoma composed of columnar cells, mucocytes, and squamoid cells showing solid and cystic lesion. Several small cysts lined by benign ciliated columnar epithelia suggesting that this tumor had originated from solid cell nest were seen around the tumor. By immunohistochemistry, columnar cells and squamoid cells in mucoepidermoid carcinoma were positive for cytokeratin but negative for thyroglobulin, TTF-1 and calcitonin. Positivity of p63 was seen in squamoid cells and basal cells of cysts. Some mucocytes are CEA positive. Tumor cells of papillary carcinoma are positive for TTF-1, thyroglobulin but negative for CEA, calcitonin and p63.

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Histopathological findings of the tumor. (A) There are foci of transition from follicular variant of papillary carcinoma to mucoepidermoid carcinoma, H&E stained, ×40. (B) Papillary carcinoma cells show nuclear groove, ground glass nuclei and intranuclear psudoinclusions, H&E stained, ×400. (C) Mucoepidermoid carcinoma is solid and cystic lesion composed of columnar cells and squamous cells, H&E stained, ×40. (D) Columnar tumor cells have cilia, H&E stained, ×400. (E) Mucinous material in cystic space, mucocytes and cytoplasmic border of columnar cells are positive by PAS staining, ×200. (F) Small cysts lined with ciliated columnar cells (solid cell nests) are seen around the main tumor, H&E stained, ×200.
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Figure 1: Histopathological findings of the tumor. (A) There are foci of transition from follicular variant of papillary carcinoma to mucoepidermoid carcinoma, H&E stained, ×40. (B) Papillary carcinoma cells show nuclear groove, ground glass nuclei and intranuclear psudoinclusions, H&E stained, ×400. (C) Mucoepidermoid carcinoma is solid and cystic lesion composed of columnar cells and squamous cells, H&E stained, ×40. (D) Columnar tumor cells have cilia, H&E stained, ×400. (E) Mucinous material in cystic space, mucocytes and cytoplasmic border of columnar cells are positive by PAS staining, ×200. (F) Small cysts lined with ciliated columnar cells (solid cell nests) are seen around the main tumor, H&E stained, ×200.

Mentions: On microscopic examination, the tumor did not have fibrous capsule and infiltrated into surrounding soft tissue. The tumor was composed of follicular variant of papillary carcinoma and mucoepidermoid carcinoma. They were focally intermingled and showed transition from papillary carcinoma to squamous epithelium arranged in sheets (Fig. 1A). Papillary carcinoma tumor cells showed nuclear groove, ground glass nucleus and nuclear pseudoinclusion (Fig. 1B). Mucoepidermoid carcinoma revealed three cell types: columnar cells, mucocytes and squamous cells (Fig. 1C). Columnar cells made ductal or cystic structures and contained eosinophilic material. Some columnar cells in tumor glands showed cilia (Fig. 1D). Squamoid cells showing cytoplasmic keratinization and intercellular bridge were present in solid sheets. Alcian blue and PAS positive mucocytes were mixed with columnar and squamous cells. Eosinophilic material in ductal or cystic structures was also positive for alcian blue and PAS stains (Fig. 1E). Columnar and squamous tumor cells showed mild to moderate nuclear atypia with rare mitosis. A few aggregates of small cysts lined by benign ciliated respiratory epithelial cells and containing mucoid material are seen at the periphery of the tumor (Fig. 1F).


Composite follicular variant of papillary carcinoma and mucoepidermoid carcinoma of thyroid gland: a case report.

Jung YH, Kang MS - J. Korean Med. Sci. (2010)

Histopathological findings of the tumor. (A) There are foci of transition from follicular variant of papillary carcinoma to mucoepidermoid carcinoma, H&E stained, ×40. (B) Papillary carcinoma cells show nuclear groove, ground glass nuclei and intranuclear psudoinclusions, H&E stained, ×400. (C) Mucoepidermoid carcinoma is solid and cystic lesion composed of columnar cells and squamous cells, H&E stained, ×40. (D) Columnar tumor cells have cilia, H&E stained, ×400. (E) Mucinous material in cystic space, mucocytes and cytoplasmic border of columnar cells are positive by PAS staining, ×200. (F) Small cysts lined with ciliated columnar cells (solid cell nests) are seen around the main tumor, H&E stained, ×200.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2967012&req=5

Figure 1: Histopathological findings of the tumor. (A) There are foci of transition from follicular variant of papillary carcinoma to mucoepidermoid carcinoma, H&E stained, ×40. (B) Papillary carcinoma cells show nuclear groove, ground glass nuclei and intranuclear psudoinclusions, H&E stained, ×400. (C) Mucoepidermoid carcinoma is solid and cystic lesion composed of columnar cells and squamous cells, H&E stained, ×40. (D) Columnar tumor cells have cilia, H&E stained, ×400. (E) Mucinous material in cystic space, mucocytes and cytoplasmic border of columnar cells are positive by PAS staining, ×200. (F) Small cysts lined with ciliated columnar cells (solid cell nests) are seen around the main tumor, H&E stained, ×200.
Mentions: On microscopic examination, the tumor did not have fibrous capsule and infiltrated into surrounding soft tissue. The tumor was composed of follicular variant of papillary carcinoma and mucoepidermoid carcinoma. They were focally intermingled and showed transition from papillary carcinoma to squamous epithelium arranged in sheets (Fig. 1A). Papillary carcinoma tumor cells showed nuclear groove, ground glass nucleus and nuclear pseudoinclusion (Fig. 1B). Mucoepidermoid carcinoma revealed three cell types: columnar cells, mucocytes and squamous cells (Fig. 1C). Columnar cells made ductal or cystic structures and contained eosinophilic material. Some columnar cells in tumor glands showed cilia (Fig. 1D). Squamoid cells showing cytoplasmic keratinization and intercellular bridge were present in solid sheets. Alcian blue and PAS positive mucocytes were mixed with columnar and squamous cells. Eosinophilic material in ductal or cystic structures was also positive for alcian blue and PAS stains (Fig. 1E). Columnar and squamous tumor cells showed mild to moderate nuclear atypia with rare mitosis. A few aggregates of small cysts lined by benign ciliated respiratory epithelial cells and containing mucoid material are seen at the periphery of the tumor (Fig. 1F).

Bottom Line: By immunohistochemistry, columnar cells and squamoid cells in mucoepidermoid carcinoma were positive for cytokeratin but negative for thyroglobulin, TTF-1 and calcitonin.Positivity of p63 was seen in squamoid cells and basal cells of cysts.Some mucocytes are CEA positive.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Pusan Paik Hospital, Inje University, Busan, Korea.

ABSTRACT
A 50-yr-old male presented a thyroid mass with dysphasia and hoarseness. He underwent total thyroidectomy and neck node dissection. Pathologically, the tumor had two distinct tumor components with intermingled areas: follicular variant of papillary carcinoma and mucoepidermoid carcinoma. Mucoepidermoid carcinoma composed of columnar cells, mucocytes, and squamoid cells showing solid and cystic lesion. Several small cysts lined by benign ciliated columnar epithelia suggesting that this tumor had originated from solid cell nest were seen around the tumor. By immunohistochemistry, columnar cells and squamoid cells in mucoepidermoid carcinoma were positive for cytokeratin but negative for thyroglobulin, TTF-1 and calcitonin. Positivity of p63 was seen in squamoid cells and basal cells of cysts. Some mucocytes are CEA positive. Tumor cells of papillary carcinoma are positive for TTF-1, thyroglobulin but negative for CEA, calcitonin and p63.

Show MeSH
Related in: MedlinePlus